American Industrialization from Civil War to WWI Essay

Between the Civil War and the end of World War I, industrialization played an ever increasing role in the economic, social, and political development of the United States. Industrialization had a huge impact on American in all of these ways, such as many Americans moving from the rural areas to urban areas, living the big city lifestyle with Industrialization on the rise. Social Darwinism also known as Survival of the fittest took an impact during this time period, the nation was facing great changes causing many people to begin new lifestyles. People began working in factories and big buildings instead of on farms. Labor unions also were formed to protect the workers from unfair wages, long days, unsafe conditions, etc. Although there were positive effects during this time there were also negative effects on the social, political, and economic, aspects of the United States. First I will go over how industrialization affected America economically. Industrialization was at a rise during this time many â€Å"Big Shot† industrialists became quite wealthy from this, although most industrialists used ruthless business tactics to accumulate their wealth. Andrew Carnegie believed in the moral duty of the rich giving back to the community so he spent much of his wealth paying for libraries, universities, trust funds, and Carnegie Hall to be built also creating more jobs (Shown in Document 8). Another Economic effect on the United States was the American entry into WWI. The army for the United States wasn’t as prepared for the modern campaigning military action like other European nations. America’s productive strength made up for that by boosting billions of dollars and our industrial potential caused its share of world manufacturing output to be 2 and a half times that of Germanys. Our entry transformed the balances and compensated for the collapse of Russia at the time (Shown in Document 9) this being a positive of American industrialization. Next I will discuss the social impact industrialization on the United States. Due to such the high demand for employees and work at the time working conditions weren’t always so great. Clara Lemlich a labor union strike leader sparked the 1909 walkout of shirtwaist makers. The strike occurred because workers were making about $6 a week on a good week, are constantly at their machines from 7am to 8pm daily with only one 30 minute lunch break. This strike gathered the public’s atten tion fueling the creation of labor unions and labor laws (Shown in document 6A). Due to poor  working conditions, unsafe and unhealthy work environments, and children working started the creation of labor laws. One of the first of these was the Laws of the state of Illinois and their passage of the 38th general assembly. Some of these laws were if upon inspection such workshops shall be found unhealthy/infectious orders will be given and actions taken as the public health shall require. Another law passed was children under 14 are prohibited from being employed; also no female shall be employed in any factory or workshop for more than 8 hours a day or 48 hours a week (Shown in document 4). Industrialization from the Civil War to World War I affected the social aspect of the U.S. by drastic changes, changes the American people were not used to this is where Social Darwinism comes into play. Next I will cover the political changes industrialization caused during this time period. The â€Å"Captains† of Industrialization during this time were arrogant, such as Mr. Rockefeller they believed they were above the Government and politicians. This created Bad Trusts that reduced competition and drove up prices. Theodore Roosevelt the president at the time became a trust buster, by creating the Sherman’s Antitrust Act in 1890 this declaring all combinations of in restraint trade now illegal (Shown in document 7B). Another example of the political impact was the Boss tweed and Tammany Hall scandal. Tammany hall was a political organization formed in 1786, and played a major role in controlling New York City and New York State politics. Boss Tweed was an American politician and the â€Å"boss† of Tammany Hall. Boss tweeds control over the political patronage in NYC through Tammany Hall as well as the tension between political leaders an industrialization â€Å"kings† lead to Boss tweed having and unfair add vantage over other candidates, ensuring loyalty of voters through job offerings. The outcome of this later resulted in Tweed’s conviction for stealing an estimated $25-$45 million dollars from NYC tax payers due to political corruption. In conclusion the era between the Civil War and World War I’s industrialization played an ever increasing role in the economic, social, and political aspect of the United States in both negative and positive aspects. Economic changes ranged from where the people mainly lived and types of jobs to how they changed. As well as labor unions and labor laws changing working conditions, to the American entry into WWI. Social changes ranged from the era of reform, the women’s rights movement  and the 19th amendment and their right to vote, as well as women causing rallies and strikes. Lastly the political changes ranged from Theodore’s Roosevelt’s â€Å"Trust Busting† to political greed and corruption.

Aboriginal stolen generation Essay

Given the ongoing and intergenerational effects of being taken away, is it useful to think of the Stolen Generations as something that happened in the past, or as a contemporary issue affecting Indigenous peoples? What implications are there for all Australians in recognizing the need for national healing? The Stolen Generation was a time of grief, sorrow and sadness for many indigenous people. To say that it is something of the past would be distorting the seriousness of the issue, the Stolen Generation was and always will be a contemporary issue affecting indigenous people. Although race relations in Australia have been signified for many decades there still remains a historic distinction between ‘black’ and ‘white’ people and this is why Australians are faced with the implications of recognizing the need for national healing. The immediate impacts of the Stolen Generation left many children feeling incomplete, lost and alone. The Stolen Generation continues to impact upon contemporary Indigenous spiritualties as the removal of a complete generation of children from their families has had a negative effect on the ability of these children to maintain their cultural identities, spirituality and their own sense of belonging to the world. The implications left for Australians in recognizing the need for national healing are extensive, Australians can be seen as the ones who need to continually fix the wrongs of the past, and although the nation strive towards coherence between Indigenous people and contemporary society it will never change what has already happened. The initial impacts of those victims of the stolen generation began with the direct disconnection from family members and the harsh reality that they were now separated from loved ones, which in some cases was forever. This factor in particular is one of the leading reasons that indigenous people are affected by the Stolen Generation as a contemporary issue in today’s society. Family is what provides a sense of closure and connection in an individual’s life. To have been stripped of that at such a young age leads to many complications and developmental issues that still haunt many indigenous people today. Many indigenous people are now suffering and hurting because of what occurred, and what they were faced with. As evidenced in one of many testimonies from victims of the stolen generation Frank Byrne is just one of many who are hurting, as he says that, â€Å"It’s very important to tell people our stories because we are hurting. It hurts. We lost our family and we didn’t bring that on. It was the Government. Why? We don’t know why. We’re just as human as everybody and we’re hurting†¦Ã¢â‚¬  The contemporary issue being represented is evident that the Stolen Generation is not something that can ever be put in the past, Frank was born in 1937 and taken away a short time after, if he is still hurting almost 70 years later then that should be enough to prove that the issue of removing children from their families at such a young age is a very serious one. Whilst indigenous people have suffered ongoing pain, there have been developments in addressing their desire for closure, and their need for an apology was finally addressed. However, the negative implications left for Australians in helping them heal can be seen as what really impacts upon the way in which Australians are able to help in the healing process. It can be seen as unfortunate that today’s societies are the ones who pay for the mistakes of the past and for some Australians it may be a burden thrust upon them that’s existence might not ever cease. It is assumed by many that no matter how much is done, Australia will always pay for the occurrence of the Stolen Generation and in a way that can be deemed true. It is more than obvious that suffering did not start and finish for members of the indigenous communities, suffering started many years ago and will remain, the brutality and seriousness of the issue does not simply heal with time or become a memory it is immovable from the world, and most importantly from those who suffered. In saying this however, there are others willing to help in achieving a positive connection with the members of the indigenous community, in particular those affected by the Stolen Generation. This can be seen through various orgainisation who thrive for a better society and aim at helping those in need of healing to heal and be given the closure they deserve. For example, ‘The healing foundation’ is a government run orgainisation with a main goal and belief that ‘We can close the Gap by supporting Aboriginal and Torres Strait Islander people to build stronger communities, heal the trauma, and preserve and celebrate our culture and our people’. Various healing programs are run through this orgainisation and they all aim to target different aspects that need to be addressed, eg; holding healing camps on country- This could ultimately help restore the connection to land that was once lost when removed from it, being in a place where you feel most comfortable would in due course enable indigenous people to strengthen that connection to the land, and in affect from that help their pain. The pain of the past, and the impact it has on the present is left with individuals from the Stolen Generation. It is safe to say that up until this present day Indigenous people are frowned upon by many, and are discriminated based on their race and opinions on what kind of people they really are. This in turn leads to the exclusion of individuals from society, and then the feeling of being rejected and neglected. This feeling has then impacted many to resort to violence &crime, alcohol abuse, drug abuse and in extreme cases suicide. However, whilst some resort to these negative responses, most are the victims of abuse and crime. According to the Australian Bureau of Statistics the crime rate for indigenous people on average, are considerably higher crime victimisation rates. In 2008, around one-quarter (23%) of Indigenous people aged 15 years and over reported being a victim of physical or threatened violence in the last 12 months, and one in seven (15%) had experienced at least one episode of physical violence in the previous year (ABS 2010c). In 2009 in the Northern Territory, police recorded 5,985 Indigenous people per 100,000 Indigenous populations as victims of assault in 2009 compared to 1,150 non-Indigenous people per 100,000 non-Indigenous populations. The figures speak for themselves, being a part of the Stolen Generation may not only be the reason that indigenous people are secluded and victimized, but it does account for the distinction between them and the rest of the community. Being victimized becomes a very serious contemporary issue as it now creates the start of an ongoing chapter, where Indigenous people are targeted based on their race and who they are believed to be. It creates a polluted society where negative connotations are what define people, when it should at no time come down to that. Australians need to recognize the need for national healing, and address such issues like violence so that it sooner or later becomes non-existent. The implications for this that Australians are left with are to help those who are victims of abuse, and support the people of the Stolen Generation who need supporting. As outlined in the ‘Bringing them home report’ many homes that children were placed in were extremely cruel, and most suffered from sexual and physical abuse. It was evident that most in power abused their positions and as a result the Indigenous people were the ones who underwent the constant exploitation. In recognizing the need for healing all Australians are faced with the realization that because of this most indigenous people are sensitive to change, do not adapt well with strangers and as a result are separated from society. In helping break that barrier and minimize these effects it is important to enable space for change and recognition of the rights and needs of the indigenous communities, especially the ones directly impacted by the after math of the Stolen Generation. When they were taken away Indigenous people were not only stripped of their families, homes and belongings but they were stripped of their identity’s. Did not matter what their name was, who they were, or where they came from. Losing your identity and being forced to change so rapidly and harshly carried so many negative consequences for those who fell victim to the change. It is because of this that today, in our society many people are still impacted and lost in finding out who they really are or where their family could be now. Being forced to assimilate into a ‘white’ Australian fell under the ‘White Australia Policy, 1901’ The policy broke important cultural, spiritual and family ties which crippled not only individuals, but whole families and even whole communities. This as a result outlines the need for society today to be understanding and acknowledge the sensitive situation that most people may still be in. There is no greater struggle in life than finding out who you are and to have been broken from any connection which could ever lead you back home will most definitely leave Indigenous people broken for many generations to come. The impact this brings to Australian society is that the issue of social justice arises and again the division between indigenous people and Australians is made evident. The suffering of being separated from family is something that was stowed upon indigenous peoples by the white Australians at the time. The constant questioning of ‘why us?’ is probably such a question left un answered by many, this leads to the implications that some Australians may feel as though it is not their role, nor fault to be the ones to acknowledge and say sorry for what has happened in the past. Although this may cause a stir for some, it is the current nation and generations to come job to ensure that the feeling of displacement and lost identities are retrieved. The separation from family not only meant a lost identity for most, but also a disconnection to their land which thus impacted their spirituality and involvement in practicing their beliefs. The issue of land rights, and the way in which indigenous people present themselves to this day is still an issue in society. Indigenous people are prone to, and enjoy being outdoors to practice their faith, for some this may be seen as intimidating, wrong, or strange but in order for healing to be achieved the Australians of this contemporary society need to acknowledge these needs of practicing their faith, and enjoying their outdoor surroundings. Indigenous people all over the world are suffering with the emotional and physical trauma of being part of the Stolen Generation. It is not something that will fade away with time, nor will it ever be forgotten about, the Stolen Generation was a horrific time for everyone who was involved and it’s the job of Australia today and in the future to right the wrongs of the past and enable the healing process to take place effectively. Bibliography ABS (September 2013). Measures of Australian progress. Retrieved September, 2013, from http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/1370.0~2010~Chapter~Aboriginal%20and%20Torres%20Strait%20Islander%20peoples%20(4.4.6.2 Press, R. W. (Septemeber 2013). Stolen Generations Fact Sheet. Retrieved September, 2013, from http://reconciliaction.org.au/nsw/education-kit/stolen-generations/#impact Australian Human Rights Commission (September,2013). Australian Human Rights . Retrieved September, 2013, from http://www.humanrights.gov.au/ Byrne, F. (September, 2013). Testimonies . Retrieved September, 2013, from http://stolengenerationstestimonies.com/index.php/testimonies/1020.htm Australia, H. P. (September, 2013). Healing. Retrieved September, 2013, from http://healingfoundation.org.au/healing-programs/

Living experience of a person of another race Essay

Living experience of a person of another race - Essay Example Additionally the book brings out an aspect of female discrimination and how they were not given a position in the society. If I was born black and was in the shoe of the young black lady, I think my life would have been harder. People of color were discriminated more that the Asian, in fact, the Asians faced discrimination mainly because they were thought to be brighter than the white. Secondly, the white felt that Asians would take over. As much as all immigrants faced racial discrimination, the black people were more oppressed, because of the color and the fact that they were seen as illiterate hence considered inferior, especially the female. If I was in a colored skin, I would not have an opportunity to experience some opportunities because black women were not even give a chance by their community to have a profession. Unlike the Asian where the society encouraged their girls to study so that they can be able provide for their family financially. Asians also believed in a strong culture that emphasis on the connection between efforts and achievement. Being born black especially as women one was reduced to a state of enslavement working as a salve, nannies in their master homes and in fields. The pay was minuscule. Black people were victims of racism, chauvinism, and manipulation specially the black woman. Therefore, they had no voice in the society and the black men also did not give them the chance and considered them as inferior too, and their role was to look after their family. That is why in the book Bell narrated how it was sickening to have to do things to please his brother. This demoralized the young black girls since they did not have a role model in the society, neither were they give a chance to go to school. Furthermore, they did not have people to push them to acquire good education as the Asian. Most grew up knowing

The Effects of Social Media in Today's Society Research Paper

The Effects of Social Media in Today's Society - Research Paper Example Anyone with an internet connection can access social networking sites. Since 1975, when the first type of social networking was introduced in the form of Hotmail, social media has come a long way. It has been observed that social networking sites like Facebook and Orkut lead to time wastage, but their benefits cannot be completely ignored. This research paper aims to measure the positive and negative effects of social media on society. Who do social media reach and how can it influence people’s lives? Social media is accessible to anyone who has a simple internet connection at home, office or anywhere in his or her environment. It is reachable to people from all walks of life, from students to business professionals. Websites like MySpace and Bebo help connect friends and family by bringing them under a single platform. Similarly, social networking sites like eBay bring buyers and sellers to exchange commodities between them. In short, social media helps B2B (business to busin ess), B2C (business to consumers) and C2C (consumers to consumers) interact, share information or files, and trade all under a single platform (Hendricks, 2012). Social media influences our life and daily routine in a great many ways depending how we utilize these networking tools. Time is of essence, and this is what it helps save. People find it much easier to go online and read articles and electronic books rather than newspapers or books that are physical in nature. In this fast moving world, people have adapted to the technological development made especially in the last decade. There has been a huge decline in book reading as people have turned to social media to meet their reading needs. Social media is changing the social habit of people. Though eBooks save time, they cause massive exertion and fatigue (Coupland, 2012, p. 103). People find it much easier to shop online than to physically go to shops and malls to make purchases. Social media is changing the way people shop no wadays. Products can be ordered with just a single click and can be delivered right at the doorsteps. Such facilities have made life very convenient for people. However, there are major drawbacks of shopping online. People have become more careful when making purchases. Buyers often complain that the products delivered to them do not match the seller’s description. In some cases, they were charged twice as much as the initial cost. Cybercrimes are on the increase, and many people have reported crimes against identity and credit card thefts (Close, 2012). How social media can change the global climate Social media can change the global climate by making people aware of the rise in global pollution and the damage it is inflicting to the ozone layer. Altogether, about 300 million people use various types of social media and upload around 220,000 videos on YouTube on a diurnal basis. Such is the power of social media, and if these people can be reached with an effective message, then the results could be very successful. Efforts are being made with a simple plan in mind. Most charitable and non-governmental organizations have joined hands for a peaceful revolution against massive pollution. The main idea is to create a community on social networking websites and blogs and try to get as many likes as possible. Frequently posting articles helps educate the readers about the dire consequences of pollution and how the planet can be saved. These articles are read and then shared by readers with their friends and

Hank Aaron or Barry Bonds Essay Example | Topics and Well Written Essays - 750 words

Hank Aaron or Barry Bonds - Essay Example Bonds did smack five homers in 42 at bats in a cameo return in September, increasing his career total to 708, seven short of surpassing Ruth as the most prolific lefthanded power hitter ever. Bonds, 41, vowed to play next season with a slimmer physique to reduce the wear on his body. His first test drive will be as a DH in the World Baseball Classic in March. Given his age and surgical history, the condition of his knees appears to be the only thing keeping the Giants' leftfielder from slugging his 756th homer and overtaking Hank Aaron's alltime record by June 2007. Major League Baseball will be conflicted about how to celebrate Bonds's eclipsing Ruth. Scores of security agents will patrol the outfield seats to verify possession of the 715 ball. Should it occur on the road, pockets of fans will boo. Whatever ceremony is staged will be muted because of Bonds's connection with BALCO. The occasion will take place without the commissioner of baseball, who will claim no obligation to be on hand for a player securing second place on an alltime list. The top spot will be a different story, forcing Bud Selig to attend, where he will applaud politely. Send his butt to first. Don't even think about pitching to him. I don't care if no one's on base. Let's not have him beat us in the first inning. I'd rather have him on first with the bases loaded than those guys out there in the water fighting over a ball. And so it goes with Barry ... In turn, the hostility between Barry and the media is real - as real as his feared black bat, as real as his rock-hard body, as real as his focus to do his job without regard to what anyone says about him. Bonds' Godfather Willie Mays says, "He thinks no one likes him." Mays and Barry are total opposites. During his career, Mays was an engaging personality, but he could be mean as the devil to reporters he didn't like, and those he didn't trust. In that respect, he shares a common bond with his godson, who in July will turn 40 years of age. This season, Barry is sitting on 10 homeruns, 28 runs scored, 27 hits, 22 RBI and an .818 slugging percentage - tops in all of baseball. In 33 games, he's had 77 batting attempts, 56 of them walks. Absolutely every manager in baseball has taken the bat out of his hand. He's a patient one at the plate, so he's not going fishing. Let's go back to the Mark McGwire year of 1998 when Mark hit a MLB record-busting 70 homeruns. If you dissect that season you will discover a raw number of pitchers who threw batting practice pitches to Mark as he surged towards the record. It was like, here comes a fast one down the middle. It was almost the same with Sammy Sosa, one of baseball's most popular players. No such thing for Bonds, however. Hardly anyone wants to see him past Babe. And another thing, virtually every time there is talk of Barry and the record, it's always, "Will he pass Ruth" The hell with Ruth; Bonds is chasing Aaron. The Babe is only in the way. In one game earlier this season, Barry drew four intentional walks to first base. He's without question the greatest player of his time, and arguably the greatest player of all time. A six-time MVP, no one

Jhonsan&jhonsan case Study Example | Topics and Well Written Essays - 250 words

Jhonsan&jhonsan - Case Study Example Johnson & Johnson has used the diversification strategy for international expansion and gaining more competitive advantage in the market. It has developed over 200 companies across the globe and deployed 120,000 employees in these companies (Award, 2010). The corporate strategy aims at improving the Johnson & Johnson’s structure through proper organizational design. The design has led to the formulation of a decentralized divisional structure which has encouraged the proper flow of information. It has also enhanced working relationships between activities and functional department. Furthermore, the decentralized divisional structure has allowed different stakeholders with different skills to bring together different technologies and products. This has led to satisfying the unmet needs of customers (Award, 2010). Synergy has assisted the Johnson & Johnson to acquire sustainable competitive advantage. The CEO Weldon has come up with a decentralized divisional structure to foster synergy. He has used the structure in assessing external environment to identify a number of forces. The first one is demographic that determine how population growth have affected demand of Johnson & Johnson’s products not only across New Brunswick, USA, and New Jersey but also in 60 countries in the globe. The second one is socio-cultural factor that examine social issues such as poverty that affect the purchasing power of Johnson & Johnson’s products by the people in the globe (Award, 2010). The third one is technological factor which determines the available healthcare technology such as Cougar Biotechnology and breast implant maker. The next factor is political which examines the requirement that local and national authorities expect Johnson & Johnson to meet in supplying and handling health care products. The last one is economic factors that reveal how currency fluctuates and how it may affect the costs of

Terrorism and the Media Case Study Example | Topics and Well Written Essays - 750 words

Terrorism and the Media - Case Study Example Law enforcement officers immediately narrowed down on two brothers, Tamerlan and Dzhokhar Tsarnaev, as the prime suspects in the bombings. Following an extended man-hunt for the then-unidentified suspects, the police bumped into Tamerlan and Dzhokhar Tsarnaev in Watertown, Massachusetts, and a massive gun battle ensued. Tamerlan Tsarnaev was shot in the gun fire and was pronounced dead shortly afterwards. Dzhokhar somehow managed to escape the police dragnet, but was later on apprehended and up to date remains under federal custody (Bodden, 2014). The Boston Bombings attracted intense interest from the public and, as expected; the media took the center-stage in disseminating information, both substantiated and unsubstantiated. During the investigation, for instance, media came under heavy criticism for making unconfirmed conclusion and reporting inaccurately on the unfolding events. The 24-hour real time new cycle implied cut-throat competition among news agencies, all looking forward to feeding the anxious public with the most recent news event. In one case, some media agencies reported that the â€Å"person of interest† following the bombing was a Saudi national while another medium reported that there were several explosive devices planted in Boston. CNN, a leading new agency not only in US but across the globe was not spared from this media frenzy. As a matter of fact, it was after CNN’s inaccurate reporting of a â€Å"dark-skinned† suspect with â€Å"brown skin† suspect that the FBI had to iss ue a warning to all media houses to desist from premature reporting. An analysis of media’s role into emergency response following Boston bombing was significantly positive. Since journalists were already at the scene at the instance the bombings occurred, they covered the magnitude of the damage caused and broadcasted the same information in

World Health Organization and Health Information Systems Research Paper

World Health Organization and Health Information Systems - Research Paper Example Scientific advancement has shown a sharp decrease of mortality rate and early detection and vaccination of infectious diseases such as: Small-pox, Polio, Diphtheria, Tuberculosis, Whooping Cough and more recently Hepatitis-B, Swine-Flu and Cervical cancer. W.H.O. fulfils its objectives through its core allocated functions: i) whenever a sole decision is to be taken among two, W.H.O. take the leadership role. ii) it shapes the research agenda and ensures the generation, translation and distribution of valuable knowledge; iii) it sets patterns and standards and promotes and monitors their implementation; iv) coherences ethical and evidence-based policy options; v) provides technical support, boosts change and builds sustainable institutional capacity; and vi) assess health trends and monitors the health situation (Lee,2009, p.xiii). With the implementation of Information System, every field of the society including the World Health Organization are facing improvement at a very fast pac e. Information System is at the core of the health care profession. It has a massive progression in Health Care division in its different fields like electronic patient registries, management system, process and programmable evaluation and also in decision support system for clinics and diagnostic centers. It cuts down the cost and by manpower reduction and sophisticated technologies and proper implementation. Both the organization and the system have to be transformed in the right manner in order to effectively implement the process. Information System management is a careful act balanced between the organization and the system (Berg, 2001). This research explores the different information technologies like Health Information System, Decision Support System, Electronic Data Interchange, Internet, Tele-medical and Medical Images that are used in World Health Organization in the developed countries and analyses its advantages, problems and the impacts of those problems that can affec t the Health Organization (Scielosp, 2004). Issues to be investigated World Health management department are very actively and effectively improving the various sectors to protect the population health. Few countries in different parts of the world today are using comprehensive systems to maintain this database. The organization has to take decisions on critical situations like measuring whether the policies and programs are working efficiently or not for different diseases like H.I.V. and A.I.D.S., malaria and tuberculosis as well as maintaining funds and workforce management. According to the World Health Organization, there are multiple benefits of using Information Management System (Carlson, 2007, p.1). WHO Health Focus The main aim of the World Health Organization (WHO) is to pursue activities that would help in generating better health standards for individuals across the world. Different schools of thought have different opinions with regards to the manner of achievement of the goals underlined by the organization. The aspect of defining a guiding principle to the organization with regards to the achievement of its objectives call for the need to ensure designs based on a large number or multiple frameworks. Certain aspect under this

Commencement Speech for UH-Windward Class of 2023 Essay

Commencement Speech for UH-Windward Class of 2023 - Essay Example Hope that a bright future, filled with vast opportunities lies ahead. Fear that I might be entangled in the web of conflicting and confusing intricacies of professional and personal goals that none might end up accomplished. Anxious of achieving all my dreams and aspirations at once. Grateful for all the people who have, in one way or another, gave support and understanding during my incessant quest to gain more knowledge in preparation for my dream career. And relieved that my academic nightmares have finally ended. I stand here, for you today, not so much as a professional forensic photographer, but more so as a professional traveler in life who fought to delve into a career which I loved against all odds. And is it all worth it? I have absolutely no intentions to bore you to death and make you all samples of my forensic expertise. My career as a forensic photographer was all what I imagined it would be when I first dreamed of it more than twenty years ago. As you can see, the most challenging hindrance then, was my physical disability. But this seemingly detrimental barrier became my most redeeming factor which catapulted me to succeed. Impossible? Dreams and aspirations come from one’s mind and heart. When one is utterly determined to reach one’s goals, no barrier or hindrance can stand in the way. First lesson: know your goal and pursue it with valor. I am sure you all have different dreams and endeavors. Most of you have already made plans to go into careers of your choice. Some might still be ambivalent as to the specific directions. But, I am sure you have encountered people, situations, factors that block your path for success. I have encountered a lot. The Vocal Rehabilitation Officer at the US Department of Veterans Affairs, Mr. Les Sakuma, (God bless his soul – although he still shares earthly pleasures with us), advised me to pursue a degree in Business Management or Computer Science, of which I have already had

The Theory of Intelligent Design (ID) Research Paper

The Theory of Intelligent Design (ID) - Research Paper Example Scientists seek to find objects which have the same types of informational properties portraying the work of one creator, the intelligent designer. Intelligent design relies on these scientific methods to detect design in irreducibly complex biological structures by examining the complex and specified information contained in DNA. The theory of Intelligent Design argues that life and everything of nature in the universe was designed by an anonymous intelligent mind (House 17). However, proponents of this theory have been unable to disclose or prove the existence of the purported intelligent mind, leaving the burden of proof to scientists and theologians. According to House (17), evidence that the proponents of ID theory display is derived from their understanding of cosmology and Molecular Biology. As part of the argument, ID theorists used kidney as an example by claiming that the organ was intelligently designed to perform its functions and that it exhibits irreducible complexity. The proponents of the theory further direct their arguments to the bacterium flagellum, which they purport to have been intelligently designed to an extent that any detachment can lead to entire mechanical failure. House (58) demonstrates that the oddly shaped stone discovered by archeologists was an intelligent design that should have been used as a tool for digging. In order to strengthen the ID theory, Behe, a proponent of the theory employed the use of a mousetrap as an example of irreducible complexity, which he proved dysfunctional when any part would be removed. Furthermore, Rael (6) a news editor then a messenger provides a much stable debating ground for the proponents of the ID theory. According to Rael (6), there are some supernatural unique beings believed to have created life on earth. However, every step of creation was a correlative product of science and religion. Rael (7) points out that the creators of the world were capable of communicating to the human beings thr ough telepathy. The designers of life on the earth were scientists who emanated from a far planet with a keen interested in creating a cloned human being (Rael 11). It is claimed that the government of the imagined planet disliked the idea of cloned human beings for fear that the creatures might exhibit superior mental capacities and powers, which can cause troubles to the pre-existing beings (Rael 15). This compelled the scientist to conduct reconnaissance on the earth to establish its viability for human cloning. Rael (11) confirms that at the time of reconnaissance the earth was completely covered with water and dense mist. When on the earth’s atmosphere, the designers investigated the sun’s cosmic rays and realized that they were harmless to life. The scientists then trenched soil from the seabed and pilled to form a dry land. Thereafter, plants and vegetables were created from chemicals and designed to survive particular climatic conditions of different regions (R ael 13). The scientists worked for hand in hand with artists who decorated every creature with various colors. According to Rael (13), the initial creation of fish was in the form of plankton then small fish and finally large fish. Rael (14) exemplifies that the process of creation involved stiff competition from different creation groups, an act that led to the formation of frightful animals and monsters.  

Bahamian environment Essay Example for Free

Bahamian environment Essay Question: Littering and irresponsible disposal of garbage by humans is destroying our Bahamian environment. In order to define the littering we must first define the word litter. Litter refers to different waste products such as containers, papers, and wrappers that have been disposed onto streets, yards and remote areas. This means â€Å"littering† is the pollution of our environment by different litter waste. Littering not only destroys our beautiful Bahamian environment but it also affects wildlife, human health and the economy. Littering and irresponsible disposal of garbage in our environment is a very important issue, which many people overlook. Although people know littering is an illegal act, many continue to carelessly scatter their trash around nonetheless. Litter creates toxins and pollutants that are harmful to our environment. When Bahamians throw glass bottles and cigarettes in bushes and along the roads the sun reflects off of them, resulting in a fire igniting. The smoke from the fire will soon fill the air, slowly polluting and destroying the atmosphere. Litter is harmful to wildlife also. They may ingest the plastic and paper then suffer from serious illness. Small animals crawl into bottles and jars looking for food and may become stuck and slowly starve to death. Littering not only affects land creatures but marine life as well. Many marine animals confuse plastic bags, balloons, bait packets, candy wrappers and rubber with prey and eat them. Plastic bags and balloons floating in the water look like jellyfish. Turtles often eat them and choke or starve to death because they have so much plastic in their stomachs. In addition, illegally dumped items containing hazardous waste can harm the environment and have a potentially negative impact on human health. Food, packaging, and other materials left to rot provide a fertile breeding ground in which bacteria thrives, resulting in a health hazard for those that come into contact with it. Litter can also create safety problems, with items such as broken glass bottles and metal cans having the potential to cause injury to anyone that steps or falls on it. In the Bahamas, mainly in Freeport we experience many bush fires. When pollutants are left in the air we as humans inhale them, this contaminated are travels to our lungs which slowly kills them. Furthermore, littering can widely affect the economy. Due to animals consuming litter and dumping they sooner or later die. Because these animals are dying they will very shortly become extinct. With no marine life and wildlife, the Bahamas will lose it main attraction which is its beautiful coral reefs and sea creatures. With no tourists coming to see these attractions, the economy of the Bahamas will soon fall dramatically all from littering and pollution. Littering is an extremely important issue in Bahamian society that should not be overlooked. It can affect the Bahamas in ways such as environmental, economic, health and wildlife. Our beautiful country is filled with many undiscovered wonders; let us not kill them by failing to do such a small action. Throw garbage in the trash and not the sea; keep litter in your hand and not on the land. So remember â€Å"Keep the Bahamas clean, green and pristine.

Ethical Issues in Paediatric Wards

Ethical Issues in Paediatric Wards Smith, a five-day-old newborn, experienced a decrease in oxygen saturation and abdominal distension. Abdominal radiograph indicated free air in abdomen. When obtaining the consent for surgery, the parents refused the use of blood or blood products, because both of them were Jehovah’s Witness (Meadow et al., 2010). There are no absolute rights or wrongs to this case, which is based on a synthesis of this clinical scenario. The aim of this essay is to explore the ethical and cultural issues in nursing practice. Because of these problems, there are more than one solution in clinical settings to preserve human lives free form blood transfusions without violating their beliefs. Ethics is a branch of philosophy concerned with the study of rational processes for decision-making. When the parents’ decision is not the best interest for the child, the paediatric nurse should advocate for him in order to protect his rights to receive treatment according to the Code of Ethics for Nurses in Australia (ANMC 2006). The first step for the nurse in resolving the ethical dilemma like this is to provide information to the parents honestly about the child’s diagnosis, treatments, outcomes and risks. This enable the parents to make free and informed decision (ANMC 2006; Janine William 2010). During the discussion between the health practitioners and the parents, fully explained situation may help the family realize that the decision may not the best choice for the child. Next, health practitioners should strive to remain truly objective and avoid all personal, racial, cultural, religious or other bias when counselling or caring the child and the family. The parents’ autonomy should also be respected during the practice (ANMC 2008b). Thirdly, nurses should respect of the parents’ competence. Competence implies the parents level of understanding that allows them to weigh up the ethical issues posed by a clinical situation, assimilate these and reach a rational decision. Culturally effective paediatric health care can be defined as the delivery of care within the context of appropriate physician knowledge, understanding, and appreciation of all cultural distinctions leading to optimal health outcomes. However, there sometimes has the conflict between the parental authority and the child’s best interests. On the one hand, Australia Nursing and Midwifery Council (2008a) states that nurses should respect the culture, values, beliefs, personal wishes, and decisions of the patients and their families. Moreover, a basic principle in law is that a minor cannot consent to medical treatment until he or she was of or above the age of 14 years old in New South Wales, 16 years old in South Australia or 18 years old in other states. As a result, the parents, or the legally pointed guardians of the child have the rights to make the decision for treatment (Janine William 2010). On the other hand, the patient must always come first, before any vested interes t of any third party including health practitioners as well as the parents, guardians, extended family and society. Brody and Aronson (cited in Tabak Zvi 2008) argue that the patient has the fundamental right to quality medical care and the best treatment. Zohar and Langham (cited in Tabak Zvi 2008) claim that parental consent to medical treatment may negate patient autonomy. In a conflict situation as described here, when informed consent is not forthcoming, the nurse’s important role in working is to seek an alternative decision (Tabak Zvi 2008). Where a parent or guardian refuses consent to use blood products in the emergency treatment of a child (less than 16 years of age), the local, state, territory or national legislation or guidelines in regarding consent for a medical procedure must apply (Australian and New Zealand Society of Blood Transfusion Ltd 2011). Slonim et al. (2008) states that the administration of blood products to children is a common practice in acad emic childrens hospitals; Complications associated with these transfused products are rare. When blood transfusions are deemed necessary for an immature minor. Jehovah’s Witnesses believe that receiving blood from other people will damage their relationship with God. However, it is true that acute blood loss has been associated with increased mortality for decades; a blood transfusion is the best way of replacing the blood quickly (BloodSafe 2008). Due to this, several methods have been used to protect their autonomy in emergent situations where blood or blood product may be used. Office of the Public Advocate (2010) introduces the guideline of Jehovah’s Witnesses and Blood Transfusions to assist physicians and other health workers to deal with this kind of dilemma based on Guardianship and Administration Act 1986, Medical Treatment Act 1988 and Human Tissue Act 1982. In Victoria, most Jehovah’s Witnesses have a â€Å"No Blood Card†. It indicates that the person who hold this card will not receive blood or blood products in no circumstances (OPA 2010). Furthermore, there are blood transfusion alternatives, and pr actices that use no blood for elective or non-emergency surgery or as a result of traumatic injuries to address the medical needs of patients who did not wish to receive blood products or blood transfusions during medical care. The 2009 Association of Anaesthetists of Great Britain and Ireland guidelines recommend the method of cell salvage in cases where patients have refused to use allogeneic blood and blood products (cited in Ashworth Roscoe 2010). Goldberg and Drummond (2008) states administration of recombinant activated factor VII (rFVIIa) is effective solution to treat Jehovah’s Witness patients with life-threatening bleeding associated with haemophilia or trauma. Schmitt el at. (2008) recommend the use of autologous peripheral blood stem cell transplantation for high-dose chemotherapy without support of allogeneic blood products. In conclusion, clinical problems with significant ethical and cultural implications pose an ever increasing dilemma in everyday medical practice in the 21st century and rarely present a simple solution. The paediatric nurses’ role is to advocate the child’s best interest when the parents’ decision is contradictory. Individuals’ religions and cultural beliefs should be respect. In clinical settings, there are increasing options other than blood product transfusions for those who refuse blood transfusions. Reference Ashworth, A, Roscoe, A 2010, Safety of cardiac surgery without blood transfusion: a retrospective study in Jehovah’s Witness patients,Anaesthesia, vol. 65, no. 7, pp. 758-759. Australia Nursing and Midwifery Council 2006, National Competency Standards for the Registered Nurse, Australian Nursing and Midwifery Council, Dickson. Australia Nursing and Midwifery Council 2008a, Code of Ethics for Nurses in Australia, Australian Nursing and Midwifery Council, Dickson. Australia Nursing and Midwifery Council 2008b, Code of Professional Conduct for Nurses in Australia, Australian Nursing and Midwifery Council, Dickson. Australian and New Zealand Society of Blood Transfusion Ltd 2011, GUIDELINES FOR THE ADMINISTRATION OF BLOOD PRODUCTS, Australian and New Zealand Society of Blood Transfusion Ltd, Australia, Sydney. BloodSafe 2008, Children receiving a blood transfusion a parents guide, BloodSafe, Australia. Goldberg, R Drummond, KJ 2008, ‘Recombinant activated factor VII for a warfarinised Jehovah’s Witness with an acute subdural haematoma’, Journal of Clinical Neuroscience, vol. 15, no. 10, pp. 1164-1166. Janine, F William, J 2010, Health care the law, Thomson Reuters (Professional) Australia, Rozelle. Meadow, W, Feudtner, C, Antommaria, A, Sommer, D, Lantos, J 2010, A Premature Infant With Necrotizing Enterocolitis Whose Parents Are Jehovahs Witnesses,Pediatrics, vol. 126, no. 1, pp. 151-155. Office of the Public Advocate 2010, Jehovah’s Witnesses and Blood Transfusions, Office of the Public Advocate, Australia, Melbourne. Schmitt, S., Mailaender, V., Egerer, G., Leo, A., Becker, S., Reinhardt, P., Wiesneth, M., Schrezenmeier, H., Ho, A.D., Goldschmidt, H. Moehler, T.M. 2008, Successful autologous peripheral blood stem cell transplantation in a Jehovahs Witness with multiple myeloma: review of literature and recommendations for high-dose chemotherapy without support of allogeneic blood products, International journal of hematology, vol. 87, no. 3, pp. 289-97. Tabak, N Zvi, MR 2008, When parents refuse a sick teenager the right to give informed consent: the nurses role 2008,Australian Journal of Advanced Nursing, 25, 3, pp. 106-111. Xiaoyan Tang 110076121

The Role And Teachings Of The Dalai Lama Philosophy Essay

The Role And Teachings Of The Dalai Lama Philosophy Essay It is up to each of us to make the best use of our time to help create a happier world1. The mark of the 21st century embraced upon a civilization corrupted with greed for power. It originated a society that talks, walks, and breathes desire for power, and to achieve this desire it will go to any cost. It does not care how many innocent people die or how many people become homeless, all it cares about is being on top and surviving. Violence is in every corner, in every street, in every block, and pretty much in every country. To live, people are willing to kill their neighbours, more or less their own blood. Violence has engulfed all of what is in existence today. It has become a source of power, a source of desire, mankinds aspiration. Although, majority of mankind may be corrupted, there still lie those who believe and have faith in amity. A belief that one day this hunger for power will lie behind us and the future will dictate peace and uphold a place of altruism (unselfishness). Amongst these believers of hope is His Holiness, Tenzin Gyatso. Tenzin Gyatso is one who seeks to find peace even in the darkest of days. Tenzin Gyatso is the 14th Dalai Lama and a symbol for future hope for both Buddhism and his nation, Tibet. He is recognized as the reincarnation of Avalokiteshvara, a Buddha who has chosen to be reborn in order to enlighten others. The Dalai Lama embraces a genuine model of life: a model through reason and selflessness and not through force; a model which is neither harmful not hostile to humanity. The Dalai Lama governs without resorting to any means of punishment: he wields weapons against no one, ruling honourably and serenely with no hatred. The Dalai Lama preaches to cultivate compassions, and metta (kindness) for all beings. An in depth analysis of the 14th Dalai Lama, Tenzin Gyatso, and his philosophies illustrate the through non violence one can achieve inner peace. Tenzin Gyatso, more formally recognized as the Dalai Lama, is the religious Buddhist leader of the country Tibet. He is the 14th manifestation of the Bodhisattva of compassion, Avalokiteshvara. To Tibetans, this Dalai Lama is known by his title, Dalai meaning ocean, and Klein, Leslie. Sprituality in a Materialistic World. AuthorHouse, 2008. Lama meaning Wisdom2. To himself, he is Tenzin Gyatso, a simple Buddhist monk- no more no less3. His holiness was born on July 6th 1935 in a small village Takster to a peasant farm family of sixteen. Takster is a village in the eastern Tibet province Amdo. At the age of 2, Tenzin Gyatso was identified as the reincarnation of his precursor, the 13th dalai Lama, becoming the 14th in line of the Dalai Lamas. Born as Lhamo Dhondrub, he was renamed rJe btsun jam dpal ngag dbang blo bzang ye shes bstan dzin rgya mtsho srid gsum dbang bsgyur mtshungs pa med paI sde bzang po4. The tulkus (reincarnated lamas) coronation ceremony occurred on February 22, 1940 in Tibets capital, Lhasa. His education began at the age of six. At the age of 15, on 17 November 1950, he was crowned the title of Dalai Lama, becoming Tibets most important spiritual and political leader. At the age of 24, he was evaluated at the monastic universities of Drepung, Sera and Ganden. In Monlam Festival Prayer, Tenzin Gyatso took his final assessment at Jokhang where he was examined on the 3 subjects: logic, Middle Path, and the canon of monastic discipline. At the age of 25 he finished the Geshe Lharampa Degree, the Doctorate of Buddhist Philosophy. In 1989, the Dalai Lama received the Noble peace prize2. To understand Dalai Lamas preaching of non violence, first one must comprehend non- violence. Non-violence is one of the highest virtues that should be accepted by everyone, no matter if they plead to Buddhism or not. Non-violence means to refrain from vicious actions. One should not kill another living being. One should not hurt another living being. One should not pain another living being. One should not ahimsa (harm) another being. This is non-violence. According to the Dalai Lama, violence is not the key, it is not the answer to anything. 2 Mullin, Glenn H., and Valerie M. Shepherd. The Fourteen Dalai Lamas: a Sacred Legacy of Reincarnation. Santa Fe, NM: Clear Light, 2001 3 Mehrotra, Rajiv. In My Own Words: an Introduction to My Teachings and Philosophy. Carlsbad, CA: Hay House, 2008. 4 Mehrotra, Rajiv. Understanding the Dalai Lama. Carlsbad, CA: Hay House, 2008. We have two options. First, nonviolence. Second, violence- thats suicide. We have to live with the Chinese side by side. It is very essential to carry this movement of nonviolence, so that later, we can live happily. If we adopt violence on the Chinese, then Tibetans will also suffer. Some positive outcome- quite a few Chinese became sympathetic of Tibetan people. They came to me expressed themselves. Nonviolence is the best method5. Violence cannot be overcome by more violence. By responding to violence, the result will be catastrophic. On the contrary, by avoiding violence one can only hope to diminish others violence. A great example of this is the homeland of the Dalai Lama, Tibet. In 1950, the genocide of Tibet began with the Chinese army of the Peoples Republic. In 1951, the Chinese government tried to take rule over Tibet from the Dalai Lama through the seventeen-point agreement. In 1959, there was an uprising against the Chinese military; when that failed the Dalai Lama was force to flee to India. In 1959, his Holiness refuted in Dharamsala, North India where he established a government-in-exile2. The Chinese captured and imprisoned naive citizens and protestors, devastating the Tibetan culture. The Dalai Lama did not refute to foul words, he did not speak ill of the Chinese. Instead of fighting back, the Dalai Lama preaches that one should meditate and reflect on what they might have done on their previo us life that they are being tormented now. He helps people understand that if one responses by causing suffering amongst another, they are not contributing to a unity in their internal world nor to the external world. The lives they live are meaningless if it does not contribute to anything. By causing suffering they cause themselves more suffering, for in their next birth they will reborn into a worse life. The life one lives is based on the karma, action, of one in the previous life. Thus, rather than devoting oneself to harm the Dalai Lama preaches Tibetans to abstain from armed struggle and accumulate good karma to achieve inner peace. If everyone adopts and learns the morals of inner peace, no longer will there be people in this world who will cause ahimsa. No longer will there be violence. As a well-known spiritual leader and political ruler, the Dalai Lamas first and foremost 5 McLennan, Scotty. The Heart of Nonviolence: A Conversation with the Dalai Lama. WisdomPortal.com. Web. 1 Aug. 2010.. obligation is to protect his people and nation. The Dalai Lama has never ceased his people from using violence just because of Buddhist morals, but because, nonviolence is for us the only way. Quite patently, in our case violence would be tantamount to suicide 6. Some might think that by not fighting he brings upon torture to his people, but the initial purpose behind the Dalai Lama is to help his people to learn and to develop. By not fighting back he tries to show people that good does not come through war and bloodshed, by refusing to fight in the long run we secure a better future. Right now we must suffer, but the seeds to our suffering will grow a clean planet. The Dalai Lama is an idol to humanity, an advocator of non-violence. Thos who do afflict harm, the enemies, are just a test of time. With time and patience, as one accumulates good karma, the birth of amity will take place, and violence will vanquish. The enemy teaches you inner strength. Your mind by nature is very soft, but when you have troubles, your mind gets strong 7. Enemies are the test of time, for when one is surrounded by enemies one has to make important judgements. These judgements define the inne r self. If one is able to refrain from violence and overcome satanic thoughts and stay on the right path, one can achieve inner peace. Thus, through the process of non violence one achieves inner peace. When one is at inner peace with themselves in times of battle they make correct decisions and refuse to fight, ultimately causing outer peace. The Dalai Lamas believes nonviolence is connected with the free understanding of individuals. The free understanding of individuals is ultimately a path leading to mental amity. Thus, non violence originates inner peace. His Holiness, the14th Dalai Lama, believes to embark inner peace one must develop metta, (love, kindness and compassion)7. When we are non-violent and refuse to fight we attain metta in our hearts. When there is violence there is anger, hatred, 6 Bstan-Ê ¼dzin-rgya-mtsho, and SÃÅ' aÃÅ'„ntideva. A Flash of Lightning in the Dark of Night: a Guide to the Bodhisattvas Way of Life. Boston: Shambhala, 1994. 7 Piburn, Sidney. The Dalai Lama, a Policy of Kindness: an Anthology of Writings by and about the Dalai Lama. Ithaca, N.Y., USA: Snow Lion Publications, 1990. and attachment, but when there is no violence one is calm, and serene. With the origins of violence comes desire and greed, eventually leading to mental unrest. When we are kind and compassionate to others it makes others feel loved, and it helps us develop inner happiness. In one of his interviews, the Dalai Lama states: If you give way to anger, hatred, you get lost. No sensible human being wants to loose himself or herself. Hope and determination will bring upon a brighter future So in order to develop human determination you need hope. And to develop hope you need compassion, love. Love and compassion are the basis of hope and determination8. If one gives into anger and hatred they give in to inner strife. If one refuses to fury and forbids him or herself from fighting they develop love and compassion to bring upon a better future. One must first develop compassion and love towards others, and then will they receive love and compassion back. One must realize that nothing good comes without suffering. Rather than making others suffer, rather than raising weapons, one should be hopeful and determined. Good karma leads to a good life. When one develops compassion and love one achieves inner peace. Without inner peace we remain longing for desire. The Dalai Lama believes that if everyone achieves calmness, compassion, and love for others eventually one day there would not be a single person left that will cause brutality upon another. When everyone has achieved this state of happiness no longer will there be armed conflict, poverty, destruction, and prejudice. The Dalai Lama is a role model of non-violence, and believes inner peace can only be achieved through non violence. The Chinese have put Dalai Lama and his people through a lot of agony, yet he still prays for their wellness. He believes that rather than drawing upon weapons, if he holds back he will attain peace with the Chinese. That one day they will see that violence only leads to deaths; through non-violence they can reach a compromise. Tibetans refuse to fight, they decided to listen to his Holiness, and abstain from harming (ahimsa) another being. Through non-violence and compassion inner happiness and peace will develop, and likewise, through 8 Bstan-Ê ¼dzin-rgya-mtsho, and SÃÅ' aÃÅ'„ntideva. For the Benefit of All Beings: a Commentary on The Way of the Bodhisattva. Boston: Shambhala, 2009 inner peace outer peace will develop. Without inner peace one will always remain worried, disturbed or unhappy. The Dalai Lamas preachings about non-violence and metta to achieve inner peace is Tibetans hope and determination for the resolution of the Chinese Genocide. In his Dentsik Monlam prayer the Dalai Lama articulates: the violent oppressors are also worthy of compassion/ Crazed by demonic emotions, they do vicious deeds/ that bring total defeat to themselves as well as to others9. This prayer was written by the Dalai Lama when he was extremely ill and all around him was bloodshed caused by the Chinese Military. The Dalai Lama wanted his people to realize that liberation can only be achieved non-violently via altruism (unselfishness) and metta (kindness). Altruism and metta can only be achieved via non-violently. Thus through the non violent approach one achieves peace of mind. The Chinese Military will stop if the Tibetans do not respond. Violence can only grow when you nurtur e to it, by not giving it violence you forbid it from growing. According to his Holiness, the spirit of non-violence is the basis for achieving inner peace. But why should one achieve inner peace? To achieve inner peace is a step to achieving liberation. The first of the 5 Buddhist precepts is the vow to refrain from killing. That one should neither hurt nor harm (ahimsa) another being, but rather practise compassion and kindness (metta) towards them. To reach the ultimate goal of Buddhist path, Nirvana, and break through samsara, the cycle of life, one must be peaceful. To achieve enlightenment and to see things for what they really are, panna, one must reach tranquility of the mind. This calmness of the mind can only be achieved through meditation, and inner peace, not violence. The actions we take affect everyone around us, not just us, so how can you believe to be liberated when you bring harm upon others. Thus, in order to achieve inner peace and deliberate ourselves from suffering, we need to focus on others, and refrain from violent actio ns. 9 Bstan-Ê ¼dzin-rgya-mtsho, Dupchok Gyaltsen. Rabjampa, and Peter Gold. Words of Truth: a Prayer. Boston: Wisdom Publications, 1993. We can never obtain peace in the world if we neglect the inner world and dont peace with ourselves. World peace must develop out of inner act As long as the weapons are left alone in storage they cannot do any harm. A human being must use them.7. Resolution through conflict does not guarantee a solution every time. Outer disbarment comes from inner disarmament. The only true guarantee of peace lies within ourselves6. In a time of conflict, we become attached to our views and forget that everything is impermanent. Our thoughts become too clouded, and we become too ignorant. When one is no longer ignorant one achieves bodhi, total awakening. Any being who understands inner peace, and subsides in a non violent conduct is evidentially contributing to the universal peace of all beings and the exile of violence. 2.com/title/Non-violenceNon-violence means 2.com/title/co-operationco-operation where it is possible, and 2.com/title/resistanceresistance where it is not10. Through Non violence one is able to control their emotions and stay happy. Through non-violence one is able to love, be compassionate and be metta towards others, as well as live in unity with humanity. Ultimately altruism, self consciousness, and amity through equal justice and fair-play lead to non-violence. Non-violence helps one acknowledge their internal awareness pertaining to greed, desire and hatred, and their outer awareness pertaining to how their internal awareness will affect the world. This awareness is ones inner peace. His Holiness, Tenzin Gyatso, the 14th Dalai Lama has become a worldwide symbol for peace, a teacher of non violence, an inspiratio n for billions. According to the Dalai Lama the first inner awareness is that suffering exists and the way to liberate from it is through hope and compassion, not violence. Through non violence we attain inner peace, through violence we attain inner discord. Hence, the 14th Dalai Lama raises no weapons, faces no wars, and preaches for non violence to achieve inner peace, for hatred never ceases through hatred in this world; through non violence it comes to an end10. 10 Sulak, Sivaraksa. Seeds of Peace: a Buddhist Vision for Renewing Society. Berkeley, CA: Parallax, 1992.

Case Management Essay -- BUsiness, Insurance Companies, Clients

The focus of this paper is case management. Case management has evolved into a diverse profession which includes many disciplines and is exercised in many settings. Case management involves the process of coordinating multiple services on behalf of clients and has been practiced now for several decades. Many disciplines have engaged in case management and identify themselves as case managers. Case managers work with many populations and settings and play an important role in today’s society. The following analysis explores how case management developed, how it is defined, its components, and how it relates to other nursing care delivery models. All these aspects are reviewed with the purpose to show the importance of case management in the health care organization. Case Management Case management has become the standard method of managing health care delivery organizations today. In recent decades, case management has become widespread throughout healthcare areas, professionals, and models in the United States; and has been extended to a wide range of clients (Park & Huber, 2009). Regardless of the setting, case management ensures that care is oriented to the client, while controlling costs at the same time. Case management delivers quality care to patients in the most cost effective approach by managing human and material resources. Client advocacy is a strong underlying theme for all case management activities. Case managers share the same goals and standards of practice, but are multidisciplinary and have diverse academic educational backgrounds and work environments (Park & Huber, 2009). The need for case management and case managers continue to increase as new service needs, and populations are recognized.... ...jured, chronically ill, and high cost cases (Jacob & Cherry, 2007). Conclusion Only within recent decades case management has been introduced, but has been proven to be a significant segment of the healthcare workforce today. There have been several changes to case management over the last few decades, and the future for case management is very diverse. Case management offers many benefits to both the client and the health care organization. In addition, case management plays a key role in a client’s road to recovery. Most importantly, case managers have a vital role overseeing their client’s transition from the hospital setting back into the community and ensuring all service needs are met. Moreover, the opportunities and need for case managers working with many populations and settings are great, and may ultimately lead to better health for individuals.

Plea Bargains: Currency of The Courts Essay -- Law

â€Å"Rahim Jaffer case heads for plea-bargain†; former Alberta MP Rahim Jaffer was being charged on cocaine possession and drunk-driving charges; his case was likely to be resolved with a plea-bargain agreement (Makin, 2010). This is but one case of many that are settled though a plea-bargain agreement. Plea-bargaining can take the form of a sentence reduction, a withdrawal or stay of other charges, or, a promise not proceed on other charges, in exchange for a guilty plea by an accused. During discussion of a potential plea bargain agreement, the Crown Attorney and defence lawyer will look at 4 distinct sections of a plea negotiation: charge discussions, sentence discussions, procedural discussions, and agreements as to the facts of the offence and the narrowing of issues in order to expedite the trial ("Plea bargaining," 2011). According to the Department of Justice, approximately 90% of criminal cases are resolved each year by use of plea-bargaining (â€Å"Findlaw,† 2012). Despite what appears on its face to be rampant use of the plea agreement, plea negotiations are incredibly helpful to our court system. First, plea agreements serve to diminish the overload of cases and avoid lengthy trials, thus avoiding appeals of trial decisions and allowing greater access to the justice system. In turn, a less burdened court system can focus its efforts on the most serious of criminal offences thereby ensuring that such cases are handled in the manner with the greatest likelihood of securing a conviction. Overall, this judicial efficiency results in a cost savings and better allocation of resources. This paper will explore these two main benefits and also discuss potential criticisms of the plea bargain system. Plea-Bargaining has become... ..., 2012, from http://www.justice.gc.ca/eng/pi/icg-gci/pb4-rpc4.html Plea bargaining. (2011, February 28). Retrieved from http://www.victimsofviolence.on.ca/rev2/index.php?option=com_content&task=view&id=378&Itemid=197 Plea bargaining in canada. (2011). Retrieved from http://www.justice.gc.ca/eng/pi/rs/rep-rap/2002/rr02_5/p3.html Romaniuk, T. (n.d.). Centre for Constitutional Studies - R. v. Askov.Faculty of Law Home - University of Alberta. Retrieved April 19, 2012, from http://www.law.ualberta.ca/centres/ccs/rulings/Ask Tappscott. (2012). street directory. Retrieved from http://www.streetdirectory.com/travel_guide/14026/legal_matters/plea_bargaining_pros_and_cons.html Young, R. (2011, November 16). Cutbacks have some courts dismissing criminal cases. Here & Noe. Retrieved April 19, 2012, from http://www.hereandnow.wbur.org/2011/11/16/budget-cuts-court

The Impacts of Devaluation on Export Performance: The Case of Ethiopia

Agriculture plays a vital role in the Ethiopian economy, contributing 42 percent of Gross Domestic Product (GDP), 80 percent of the employment and 90 percent of total export earnings (Ministry of Finance and Economic Development [MoFED] 2011; Diao et al. 2010). In 2009 with an effort to remove the vicious socio-economic circle, the government of Federal Democratic Republic of Ethiopia (FDRE) developed a Growth and Transformation Plan (GTP) with a priority to export orientated agricultural development led industrialization (MoFED 2010 P. 22). Despite the over-ambitious plan, however, the performance of the export sector has remained undeveloped which calls for sound macroeconomic policies that are crucial to combat the bottlenecks constraining the sector. This essay examines the consequences of devaluation on the performance of Ethiopia's export sector. Foreign exchange rate is a key macroeconomic variable that determines performance of export in a country. The reasons why export performance depends on the foreign exchange regime in developing countries include: the characteristics of exportable goods, the effectiveness of financial sectors and trading with foreign currencies rather than with the domestic currency (Nilsson and Nilsson 2000). Accordingly, Ethiopia's export is characterized by primary agricultural products with inelastic export demand and supply, concentration of market and products, and little value addition. The result of primary agricultural product export is a smaller marketing margin and insignificant bargaining power on the world market. The financial sector is also constrained with higher probabilities of the existence of parallel markets that fail at allocating resources to their most efficient usage. More... ...tional Economics: Theory and Policy. 9th ed. Edinburgh Gate: Pearson Education. Melesse, Wondemhunegn Ezezew. 2011. â€Å"The Dynamics between Real Exchange Rate Movements and Trends in Trade Performance: The Case of Ethiopia.† Munich Personal Research Papers in Economics Archive (MPRA). MPRA Paper No. 29161. Munich. Michael, Nwidobie Barine. 2011. â€Å"An Impact Analysis of Foreign Exchange Rate Volatility on Nigeria’s Export Performance.† European Journal of Economics, Finance and Administrative Sciences V (37): 47-55. National Bank of Ethiopia (NBE). 2011. National Bank Annual Report 2009/10. Addis Abeba: NBE. Nilsson, Kristian and Lars Nilsson. 2000. â€Å"Exchange Rate Regimes and Export Performance in Developing Countries.† Oxford: Blackwell Publishers: 331-349. World Bank (WB). 2012. â€Å"World Development Indicators Database: Ethiopia.† Washington, DC: WB.

Importance of Partheon

One of the most well known places in Greece would be the Athenian Acropolis, where the Parthenon resides. Built in dedication to the Greek Goddess Athena, the current temple was constructed after the original temple was destroyed in the Second Persian Invasion in 480 B. C. The Parthenon is a most prominent figure in Classical Greek history, designed by Callicrates and Ictinus with the supervision of Phidias over the order of Pericles to show the wealth and the extravagance the Athenian power was capable of. Though in restoration, its value becomes clear ooking at its sculptures and realizing the extensive history it holds.Being over 2000 years old, the history of the temple is astronomical. Just by looking at it, the affects of an ancient battle and rule are clear. Construction began in 447 B. C. , and ended in 438 B. C. The Parthenon was purely a temple to Athena, up till the 4th century. The building held many treasures, the most magnificent being a statue of Athena in full armor h olding Nike, Goddess of Victory, made purely of ivory and gold. This statue was lost and eventually destroyed in the 5th century, Athens now eing a province of the Roman Empire. In the 5th century, the building was turned into a Christian church.It remained this way for around 250 years, the actual structure remaining intact, but with most sculptures of the Greek Gods destroyed. Then it was the Ottomans' who took control, and turned the temple into a mosque. Under their control, it was maintained, until the 17th century. 1678 was when the Parthenon took a direct shot from mortar fire from the Venetians, and since the building was being used as a store for gunpowder, a huge explosion occurred, leaving most of the destruction visible today. The Venetians soon took control and took whatever they could from the structure, and wrecking the rest, leaving it nearly empty.Whatever was left was then taken by the British in 1801. We can only tell what the sculptures and depictions look like t oday thanks to a Flemish artist, Jacques Carrey who made drawings in 1674. Restoration for the broken and worn building started in 1975. While the Parthenon will never look like it did centuries ago, we are now doing our best to restore it. Not only can you see the outcomes of historical events on the Parthenon, but mportant events and figures of Greek mythology are a part of, and used to be what the Parthenon was for.Just about all of the pieces involving their mythology are lost, but the ones we know of give us more knowledge on the subject. From the art left by Jacques Carry, we see the birth of Athena, which whom the temple was built for, on the East Pediment. The setting is dawn, as we see horses at the South end rising up Helios, and horses at the north end tired and fatigued. We can picture the main gods around Zeus, with Hephaestus and Hera near. Hephaestus was the one to strike Zeus's head, splitting it, after complaining of headache, giving forth to Athena in full armor.Th en there's the West Pediment, showing the aftermath of the fight between Athena and Poseidon over Attica, the region of Athens. Hermes and Nike are on the side with Athena, while Iris and Aphrodite are on the side with Poseidon. Both are moving away from the center of the pediment where Zeus threw down a thunderbolt, pediments tell of major events in mythology evolving Athena. The Parthenon has survived through time, and it tells quite a tale on Ancient Greece. It has been part of major events in history evolving Greece, and shows us important events in mythology.When we look at what the structure holds and gives to us, it's importance becomes clear. Not only is a marvel to look at, but shows us what Athens had been capable on. It has survived, but not without wounds, though steps are being taken to finally get the temple to what it used to be over 2,000 years ago. Short Essay Ancient Greece, architecture wise, is most well-known for its astounding temples. Having an important role in their religion, they were most wide-spread. The Parthenon is one of the best well-known temples, built for the Goddess Athena.Temples such as the Parthenon were very common, held an important spot in Ancient Greece, and is simply an amazing work of art. From the details of the columns to the frieze, the Parthenon was, and still is a testament to the beauty of Ancient Greek architecture. Located in Athens, the Parthenon stands on top of The Acropolis. There are actually many acropolises, but the one holding the Parthenon has its special title for its significance. There are many temples dedicated to gods, such as the Temple of Aphaea, the Temple of Hephaestus, and the Temple of Zeus.Temples are what Greek architecture is best known for, so it should be no surprise that they were fairly common. They were used as a place of sanctuary and of religious purposes. The Parthenon had its place as being built for Athena, for Athens success during that time. Not only did they serve a religi ous purpose, but a way to show power. No ordinary city would build such a work of art, you needed money and power. It also did show how artsy and amazing artists some Greeks were, you could look at the olumns and see very fine details, from the drawings you can see the realistic look of the statues placed inside, and outside the building.The fact that these very lifelike sculptures were crafted and moved without the machinery we have today is unbelievable. From the pediments, you see important bits of mythology play out before you, and from the ruins you can see the affects of time and destruction. No other work of art can hold as much history as the Parthenon has, it's been through the time of the Ancient Greece to the 21st century, all the way gathering scars from new rule and battles. I think the whole building itself is astonishing, but also very informal.While the building currently is nothing compared to what it looked like when finished long ago, knowing it is being restored lets us know this magnificent work of art has not been forgotten. The Parthenon holds a spot in Greek history, and serves its purpose in their ancient religion. While temples like it are common, none are as well known, or hold as much of a historical significance. It's a beautiful structure to behold, mostly when it is completely rebuilt. It's overall a stunning building, very fitting of a Goddesses place of worship.

Opioid Substitution Treatment Barriers Health And Social Care Essay

ISSUES. Opioid permutation intervention is internationally recognised as the most effectual intercession available to handle opioid dependance. There is concern that capacity at public clinics and pharmaceuticss is deficient to run into high demand, ensuing in a cohort of opioid-dependent patients left untreated. Research has focussed on pharmaceutics barriers to OST bringing but small is known about the public clinic sector. APPROACH. A narrative reappraisal was conducted by thorough scrutiny of relevant literature in electronic databases ; Medline, CINAHL and Cochrane. Cardinal FINDINGS. Despite the enlargement of OST and vacancies in pharmaceuticss, some opioid-dependent patients continue to confront barriers that block entree to intervention. These barriers are varied and multi-faceted. For the patient, stigma and a compulsory dispensing fee are important deterrences to pharmacy dosing. For the druggist, negative behaviors associated with OST patients such as debt, larceny and aggressive behavior and full capacity are grounds that impede proviso of OST. In public clinics, the backlog of stable patients non being transferred to pharmacy dosing is a suspected barrier that has non been extensively investigated. IMPLICATIONS. Research has explored pharmaceutics and patient barriers to OST entree but less is known about the public clinic barriers. More research is warranted into public clinics to clarify possible barriers of all grades of the OST system. CONCLUSION. This reappraisal emphasises the dearth of research into OST bringing in public clinics. Further probe into the processs of OST in clinics is necessary and should concentrate on patient appraisal, referral and direction. Keywords: opioid permutation intervention, pharmaceutics, clinic Word count: 246 Researching barriers to opioid permutation intervention in pharmaceuticss and public clinicsIntroductionOpioid dependance carries a scope of important inauspicious wellness, economic and societal jobs to the person and wider community, including the hazard of overdose, the spread of infective diseases ( HIV/AIDS, hepatitis B and C ) , psychological jobs, drug-related offense, wellness impairment and household break [ 1, 2 ] . Opioid permutation intervention ( OST ) is internationally recognised as the most good and cost-efficient pharmacological intercession available for the intervention of opioid dependance [ 3, 4 ] . In response to an addition in the Australian population of heroin-dependent users in the 1990s [ 5, 6 ] the authorities introduced OST as a injury minimization scheme to understate these inauspicious effects [ 7 ] . Since so OST bringing has steadily increased under the National Pharmacotherapy Policy and National Drug Strategy [ 7, 8 ] . The figure of patients has ri sen in surplus of 2,000 clients per twelvemonth since 2007 and at the clip of authorship, there are presently over 46, 000 clients having intervention in Australia entirely [ 8 ] . In Australia, OST involves supervised day-to-day dosing of one of three long-acting opioid replacing medical specialties ( dolophine hydrochloride, buprenorphine or buprenorphine/naloxone ) . Most new patients are initiated into intervention by the doctor at a public clinic under the supervising of a nurse or instance director. In this scene they have entree to single instance direction, reding and specialist medical support at no charge. Once they become stabilised on intervention, patients are encouraged to reassign their dosing to a community pharmaceutics [ 2 ] , thereby emancipating their dosing topographic point at the public clinic for a new patient. There is a concern that this tract is non every bit smooth as it appears. As at June 2008, an estimated 41,000 opioid dependent people in the community were still unable to entree intervention and the job is declining [ 9 ] . Confusing the job is the fact that there is no bing agencies of measuring the precise demand for intervention and no systematic monitoring of waiting times in the pharmacotherapy system [ 9 ] . Proposed accounts for this issue are varied and multi-faceted. It is believed the system capacity at both the populace clinics and the community pharmaceutics degrees may non be sufficient to suit the high demand for OST, therefore the ground why an estimated 50 % heroin-users are non in intervention. Previous surveies have investigated the pharmaceutics barriers to OST but at that place appears to be a deficiency of research into the drug and intoxicant clinics [ 10, 11 ] . This reappraisal aims to research the literature refering to OST in Australia. In peculiar the reappraisal will look into the grounds for the â€Å" unmet demand † [ 9 ] of opioid dependant patients necessitating these services and the bing barriers to the proviso, entree and consumption of OST faced by both patients and healthcare suppliers.MethodA narrative literature reappraisal was conducted by thorough scrutiny of the literature in 3 electronic databases Medline, CINAHL and Cochrane. The undermentioned keywords and phrases were searched: â€Å" opiate ( opioid ) permutation ( replacing ) intervention ( therapy ) † , â€Å" referral † , â€Å" dolophine hydrochloride † , â€Å" buprenorphine † , â€Å" pharmaceutics † , â€Å" drug and intoxicant clinic † , â€Å" drug wellness clinic † and â€Å" harm minimization † . The mentions of relevant literature were besides searched. Documents were eligible for inclusion if they were written in English and published between the old ages 2000 and 2012. Documents were excluded if they chiefly focused on detoxification plans, naltrexone intervention, dolophine hydrochloride for hurting alleviation or if they pertained to patients other than big opioid-dependent patients. A comprehensive hunt of Australian cyberspace resources was besides conducted. The primary sites were Australian national and province authorities wellness policy and statistics sites ( hypertext transfer protocol: //www.druginfo.nsw.gov.au/ , hypertext transfer protocol: //www.aihw.gov.au/ , hypertext transfer protocol: //www.health.nsw.gov.au/ , hypertext transfer protocol: //www.nhmrc.gov.au ) and the UNSW National Drug & A ; Alcohol Research Centre ( NDARC ) .RESULTS AND DISCUSSION:Several surveies have shown OST to be associated with benefits including reduced illicit opioid usage, lower associated offense rates and improved wellness results [ 3, 12, 13 ] . It has besides been demonstrated to be more extremely cost-efficient than detoxification or rehabilitation [ 4 ] . In response to increasing demand, the figure of dosing sites in Australia has increased from 2,081 ( 2005-06 ) to 2,200 ( 2009-10 ) with the major addition being in the figure of new pharmaceuticss taking to offe r OST services [ 8 ] . Community pharmaceuticss are the chief suppliers of OST in Australia, accounting for 43 % of OST patients in NSW. This is in line with other states such as the UK, France, Germany and New Zealand where pharmaceutics is emerging as a head of OST proviso [ 14-16 ] . Although pharmacy proviso of OST has expanded, there are still people who can non entree these dosing sites, restricted by certain barriers. The lone solid grounds of these people is on waiting lists, but presently in Australia there is no official demand to supervise waiting lists or capacity [ 9, 17-19 ] . Factors explicating the inability of OST plans to run into current demand are multifaceted and interconnected and scope from deficient figure of intervention topographic points depending on location to barriers faced by patients in accessing OST such as rural location or restricted dosing hours. Much research has focussed on the challenges faced by suppliers of OST services, viz. community pharmaceuticss, GPs and public clinics.OST in community pharmaceuticsCommunity pharmaceutics histories for 43 % of OST patients in NSW. Most surveies on OST proviso are survey-based. In a study of NSW public clinic patients, 80 % of participants preferable pharmaceutics dosing over the clinic [ 20 ] . Benefits of pharmaceutics that have been cited in patient studies include greater community integrating, a more stable dosing environment, flexible dosing hours, less travel clip and cost ( the patient may be referred to a pharmaceutics closer to their reference ) and the chance for regular takeout doses [ 20-22 ] . Takeouts are extremely valued by opioid dependent patients as they facilitate the standardization of life [ 21 ] . Patients can devour their dosage unsupervised and the decreased frequence of dosing attending allows clients to prosecute employment and instruction chances and fulfil household duties. Sing they are merely routinely given to stable patients in community pharmaceuticss and non by and large in public clinics, takeouts are a major inducement to pharmaceutics dosing. Although demand and patient penchant for pharmaceutics dosing is high, patients may still confront barriers that deter them from come ining into pharmaceutics intervention. Stigma Whilst patients on OST reported high degrees of satisfaction, a common issue in dosing sites was the presence of negative staff opinion and stigma [ 10, 21, 22 ] . When Deering et Al. ( 2011 ) asked New Zealand OST patients how intervention could be improved, an overpowering bulk identified ‘better intervention by staff ‘ [ 10 ] . The position that staff behavior could be improved was supported in a study by Kehoe et Al. ( 2004 ) nevertheless contrastingly 80 % of respondents besides reported that staff intervention was satisfactory or first-class [ 21 ] . This disagreement suggests that whilst patients were overall satisfied with staff intervention, they still felt the demand for betterment. Financial load Another common hindrance to OST identified in the literature is the fiscal load of intervention faced by patients [ 11, 20, 22, 23 ] . Whilst intervention costs in NSW public clinics are to the full subsidised by the province authorities, pharmaceutics dosing incurs a hebdomadal dispensing fee runing from about $ 30- $ 35 [ 22 ] . In one survey, 32 % of public clinic patients surveyed claimed they could non afford the pharmaceutics distributing fees perchance explicating their involuntariness to reassign to pharmacy [ 20 ] . The balance were merely able to pay an mean $ 10 a hebdomad, an sum well lower than $ 33.56, the average hebdomadal dispensing fee reported by Lea et al [ 22 ] . The fact that 23 % pharmaceutics clients owed the pharmaceutics money for dosing [ 22 ] confirms that a significant figure of OST clients struggle to afford pharmaceutics distributing fees. The theoretical account used in Canberra in which 50 % of the distributing fee is subsidised, [ 24 ] is intended to ease the pecuniary load and act as an added inducement for intervention keeping or entryway. No surveies have yet evaluated the consequence of lower fees on patient keeping times. From the druggist perspective client debt likewise serves as a deterrence against the bringing of OST or uptake of new patients. Other jobs related to behavioral disinhibition, aggression, larceny and the negative impact on concern and other clients have all been identified as grounds impacting druggists ‘ proviso of OST [ 25, 26 ] . In contrast to pharmacist concerns, one survey in the UK interviewed pharmaceutics clients and found the bulk to be overall supportive of pharmaceuticss presenting drug user services [ 14 ] , with the specification that privateness was necessary. The demand for equal privateness is in line with OST patient positions [ 22 ] . However qualitative informations was sourced from interviews which may be skewed by interviewee disposition to give socially desirable replies. Role of the GP prescriber Another common job experienced by community druggists is the trouble reaching prescribers and the prescribing of takeout doses to unstable patients [ 26 ] . Pharmacists identified the hazard of recreation of takeout doses and hapless appraisal of stableness as issues that required improved interprofessional coaction with prescribers. Interestingly in one survey a bulk of druggists agreed that prescriber communicating was equal, nevertheless little sample size and the rural location which tends to further closer interprofessional relationships may be accountable [ 27 ] . Winstock et Al. ( 2010 ) recommends the public-service corporation of standardized resources such as the NSW Department of Health ‘Patient Journey Kits ‘ to steer multidisciplinary attention of OST patients [ 26, 28 ] . Another facet lending to system capacity is the reduced supply of prescribers for OST. GPs are frequently the first point of contact for opioid-dependent people. They are required to set about extra preparation to go commissioned opioid pharmacotherapy prescribers [ 29 ] . GPs play an intrinsic function in the initial showing, appraisal and on-going feedback and monitoring of OST clients. The issue lies in the ripening work force and the retirement of commissioned prescribers, thereby cut downing intervention entree [ 17 ] . Public clinics are the lone prescribing option but considerable barriers including full system capacity and the deficiency of motion of stable patients out of clinics into pharmaceuticss besides limit the public clinics ability to suit excess patients. Unexplained vacancies Despite grounds of an â€Å" unmet demand † [ 9 ] , a survey conducted by the National Drug and Alcohol Research Centre ( NDARC ) found that more than half of OST-providing pharmaceuticss reported an norm of 7 vacancies to dose extra patients. Data extrapolation of to all NSW pharmaceuticss registered to present OST suggests that there are about 3000 vacant dosing topographic points across NSW. Whilst a 3rd of pharmaceuticss in the survey were runing at full capacity, some pharmaceuticss reported functioning no clients [ 18 ] . This spectrum of clients across registered pharmaceuticss and the being of current vacancies exemplify the underutilisation of community pharmaceutics dosing topographic points. However the fact that these vacancies may non ever be located where the demand is highest has to be taken into consideration. For illustration patient entree to intervention in rural locations is frequently restricted due to limited pharmaceutics Numberss and longer going distan ces [ 25 ] . From the literature, it appears NSW pharmaceuticss have the capacity to increase consumption of clients, with a possible 70 % of pharmaceuticss capable but non willing to supply OST services. Factors identified that would promote druggists to increase client Numberss include the stableness of the patient, higher fiscal additions per client and the option to instantly return unstable patients to public clinics [ 18 ] . However some public clinics expressed concern about taking back unstable patients, proposing there was no warrant of available dosing capacity, one time a new patient had been inducted [ 18 ] .OST in public clinicsEntree to OST is determined by both the handiness of pharmaceuticss supplying OST every bit good as the capacity of public clinics to take on extra clients [ 19, 26 ] . However harmonizing to an expansive NSW state-wide study on OST by Winstock et Al. ( 2008 ) , there appears to be an underutilisation of available pharmaceutics dosing sites and limited capacit y in public clinics [ 19 ] . Whilst the bulk of literature has focussed on pharmaceutics proviso of OST, relatively less research has been conducted into the public clinic grade of the OST system despite representing 19 % of dosing patients in NSW [ 8 ] . Public clinics have become an increasing country of involvement driven by studies that the motion of stable patients through the clinics out to community pharmaceuticss appears to be dead [ 17, 19 ] . This is ensuing in a backlog of patients barricading new patients from accessing intervention at the clinics. The proportion of stable patients transferred from the clinics to pharmaceuticss is estimated to be really low at 3-15 % a month [ 18 ] . Surveyed patients have cited a reluctance or inability to afford a dispensing fee and feeling dying about reassigning [ 20 ] as grounds against transportation. Precedence groups Intensifying the limited capacity of public clinics is the duty of supplying priority entree of vacancies to groups that meet standards stipulated under NSW Health directives [ 2, 7 ] . Cohorts include released captives, pregnant adult females, people with HIV, hepatitis B bearers and those on a recreation plan as ordered by the tribunal. [ 19 ] Similarly clients that show hazardous forms of illicit substance maltreatment such as those with mental unwellness and intoxicant dependance, or those that exhibit aggressive or antisocial behaviors are better managed at the public clinic instead than at a pharmaceutics. As a consequence many patients who do non run into ‘priority ‘ position are forced to wait. Obviously there is a demand to increase the efficient transportation rate of patients out to pharmaceuticss to do infinite for these clients. As antecedently mentioned, there is no consistent systematic process or set guidelines to help clinicians in covering with these iss ues and as of yet, no research has been conducted on their response to pull offing these issues. A 2008 SWAT study of NSW public clinics reported that when unable to offer immediate intervention, clinics either provided injury decrease advice referred to another public clinic, a private clinic or a GP, or offered detoxification. The assortment of actions and the effectivity of each have non been assessed and look to be decided upon at the discretion of the presiding OST practician at the clinic. Recommendations by the SWAT squad include developing a standardised response when a clinic can non offer a intervention topographic point to a client, and systematic monitoring of capacity to explicate more timely intervention in the hereafter [ 19 ] . Stability appraisal and referral processs An obstruction inherent to the pharmacotherapy system is the clinical appraisal of patient stableness and referral process. The triage function of stableness appraisal is usually coordinated by Nursing Unit of measurement Managers ( NUMs ) or a cardinal stakeholder in the public clinic and involves reexamining patient dosing history and behavior and placing those suited for transportation [ 30 ] . Currently no surveies into the clinical function or preparation of NUMs in OST proviso have been conducted. Soon determinations are guided by clinical opinion. The lone available counsel is limited to authorities policy, instead than scientific grounds and no standardized guidelines exist [ 30 ] . Whilst there are over 300 hazard appraisal instruments available to mensurate results of patients in drug and intoxicant intervention, no individual standardised attack has been nationally adopted or endorsed for OST [ 30 ] . A survey by Winstock et Al. ( 2009 ) found that execution of a province broad preparation plan improved client stableness appraisal with 25 % of staff increasing the figure of clients transferred out to community pharmaceutics [ 31 ] . However the objectiveness of this survey was affected as the method involved clinicians self-reporting cognition and accomplishments prior to and after preparation. However the survey provides preliminary grounds that acceptance of standardized appraisal processes increases the transparence of clinical determinations and can better entree to O ST [ 19, 31 ] . As above-named there appears to be underutilisation of community pharmaceutics OST services with some dosing at full capacity, whilst at the other terminal of the spectrum, some pharmaceuticss serve no patients. The bulk of pharmaceuticss reported vacancies. Whilst 75 % of clinics reportedly monitored available capacity within local pharmaceuticss, it is possible that the remainder are directing clients to overfilled dosing sites [ 18 ] . No formal survey has as of yet explored how clients refer and allocate patients to pharmaceuticss and how pharmaceuticss are selected.DecisionFrom the reappraisal of the literature, there is grounds to propose that the current opioid permutation intervention capacity may non be sufficient to run into demand for intervention. Several barriers have been identified that restrict patient entree to intervention. Pharmacy barriers include the minority of community pharmaceuticss that opt in to present dosing, pharmacist reluctance to take on new patients due to perceived associated negative behaviors and old experiences and patient involuntariness or inability to pay the dispensing fee. The deficiency of prescribers is another aspect contributing to the decreased entree to available intervention. An country of involvement is the part of the public clinic grade of the OST system, nevertheless there is an evident dearth of research conducted into the direction of OST entree in public clinics. The dead flow of stable patients reassigning dosing from the public clinics to community pharmaceuticss is suspected to be impacting entree to intervention for new patients who do non run into precedence standards and are forced to wait. There is preliminary grounds to propose that a standardized attack to stability appraisal may ease stable patient transportation and liberate dosing sites in clinics for non-priority groups. Further research needs to be conducted into the stableness appraisal and referral processs of OST, the bing tools and processs and how effectual they will be in shuting the spread between demand and supply of OST.